Individual provider Active NPI

Makenzie Rae Laase, MA, CF-SLP

  • Speech-Language Pathologist
  • North Bend, OR
National Provider Identifier
1609394147
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16016 Issued in OR
Practice address
2085 Inland Dr Ste a
North Bend, OR 97459-1203
Phone
(541) 267-5221
Fax
(541) 267-5222
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 16016 OR Primary

Addresses

Primary practice location

2085 Inland Dr Ste a
North Bend, OR 97459-1203

Mailing address

2085 Inland Dr Ste a
North Bend, OR 97459-1203
Phone (541) 267-5221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231214002035 CO Practitioner - Qualified Speech Language Pathologist 8729330063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Katey Blehm M.a. CCC-SLPGroup PAC ID 3476866880, 13 clinicians

Practice addresses (Care Compare)

8415 Explorer Dr
Suite 150
Colorado Springs, CO 80920-1034
Phone (719) 332-4689

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
16016ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Katey Blehm M.a. CCC-SLP Speech-Language Pathologist CurrentSince Dec 5, 2023 Accepting new patients
Katey Blehm M.a. CCC-SLP Speech-Language Pathologist CurrentSince Dec 5, 2023 Accepting new patients

Locations

8415 Explorer Dr
Ste 150
Colorado Springs, CO 80920
Phone (719) 332-4689

2776 Janitell Rd
Colorado Springs, CO 80906
Phone (719) 332-4689

6965 Tutt Blvd
Ste 100A
Colorado Springs, CO 80923
Phone (719) 332-4689

2776 Janitell Rd
Ofc
Colorado Springs, CO 80906
Phone (719) 332-4689

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1609394147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 INLAND DR STE A",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591203",
            "telephone_number": "541-267-5221",
            "fax_number": "541-267-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 INLAND DR STE A",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591203",
            "telephone_number": "541-267-5221",
            "fax_number": "541-267-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAASE",
        "first_name": "MAKENZIE",
        "middle_name": "RAE",
        "credential": "MA, CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "16016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.